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General NPI Number Information
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NPI Number | 1104123322
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Entity Type | Organization
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Legal Business Name | ADVANCED CHOICE CARE
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 02/24/2011
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Provider Practice Location Address
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Address Line | 1829 8TH AVE
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City | FORT WORTH
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State | TX
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Zip | 76110-1351
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Country | US
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Telephone | 817-927-9988
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 12353
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City | FORT WORTH
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State | TX
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Zip | 76110-8353
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KIEUGIANG HA HUYNH
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Credential |
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Telephone | 817-927-9988
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | F008399
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License Number State | TX
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